Survival outcomes of patients with muscle-invasive bladder cancer according to pathological response at radical cystectomy with or without neo-adjuvant chemotherapy: a case–control matching study
-
Published:2022-08-23
Issue:12
Volume:54
Page:3145-3152
-
ISSN:1573-2584
-
Container-title:International Urology and Nephrology
-
language:en
-
Short-container-title:Int Urol Nephrol
Author:
van Ginkel NoorORCID, Hermans Tom J. N., Meijer Dennie, Boormans Joost L., Voortman Jens, Mertens Laura, van Beek Sytse C., Vis André N.ORCID, Aben K. K. H., Arends T. J., Ausems P. J., Baselmans D., Berger C. P. A. M., Berrens A. C., Bickerstaffe H., Bos S. D., Braam M., Buddingh K. T., Claus S., Dekker K., van Doeveren T., Einerhand S. M. H., Fossion L. M. C. L., van Gennep E. J., Grondhuis Palacios L. A., Hinsenveld F. J., Hobijn M. M., van Huystee S. H., Jaspers-Valentijn M., Klaver O. S., Koldewijn E. L., Korsten L., Lenting A., Lentjes K. J., Luiting H. B., van der Meer S., Nieuwenhuijzen J. A., Noordzij M. A., Nooter R. I., Notenboom C. A. W., Oomen R. J. A., van der Poel H. G., van Roermund J. G. H., de Rooij J., Roshani H., van der Schoot D. K. E., Schrier B. P., van der Slot M. A., Somford D. M., Stelwagen P. J., Stroux A. M. A., van der West A., Wijsman B. P., Windt W. A. K. M., van Zanten P.,
Abstract
Abstract
Objectives
To assess survival of patients with muscle-invasive bladder cancer (MIBC) who underwent radical cystectomy (RC) with or without neo-adjuvant chemotherapy (NAC) according to the pathological response at RC.
Methods
965 patients with MIBC (cT2-4aN0M0) who underwent RC with or without NAC were analyzed. Among the collected data were comorbidity, clinical and pathological tumor stage, tumor grade, nodal status (y)pN, and OS. Case–control matching of 412 patients was performed to compare oncological outcomes. Kaplan–Meier curves were created to estimate OS for patients who underwent RC with or without NAC, and for those with complete response (pCR), partial response (pPR), or residual or progressive disease (PD).
Results
Patients with a pCR or pPR at RC, with or without NAC, had better OS than patients who had PD (both p values < 0.001). Moreover, the incidence of pCR was significantly higher in patients receiving NAC prior to RC than in patients undergoing RC only (31% versus 15%, respectively; p < 0.001). Case–control matching displayed better OS of patients who underwent RC with NAC, median survival not reached, than of those who underwent RC only, median 4.5 years (p = 0.023).
Conclusions
This study showed that patients with MIBC who underwent NAC with RC had a significant better OS than those who underwent RC only. The proportion of patients with a pCR was higher in those who received NAC and RC than in those who were treated by RC only. The favorable OS rate in the NAC and RC cohort was probably attributed to the higher observed pCR rate.
Publisher
Springer Science and Business Media LLC
Subject
Urology,Nephrology
Reference21 articles.
1. Prout GR Jr, Griffin PP, Shipley WU (1979) Bladder carcinoma as a systemic disease. Cancer 43(6):2532–2539 2. Petrelli F, Coinu A, Cabiddu M, Ghilardi M, Vavassori I, Barni S (2014) Correlation of pathologic complete response with survival after neoadjuvant chemotherapy in bladder cancer treated with cystectomy: a meta-analysis. Eur Urol 65(2):350–357 3. Zargar H, Espiritu PN, Fairey AS, Mertens LS, Dinney CP, Mir MC et al (2015) Multicenter assessment of neoadjuvant chemotherapy for muscle-invasive bladder cancer. Eur Urol 67(2):241–249 4. Grossman HB, Natale RB, Tangen CM, Speights VO, Vogelzang NJ, Trump DL et al (2003) Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 349(9):859–866 5. Hermans TJN, Voskuilen CS, Deelen M, Mertens LS, Horenblas S, Meijer RP et al (2019) Superior efficacy of neoadjuvant chemotherapy and radical cystectomy in cT3-4aN0M0 compared to cT2N0M0 bladder cancer. Int J Cancer 144(6):1453–1459
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|